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婴儿罕见的交叉性鼻筛部脑膨出合并开放性唇裂脑畸形的两阶段手术干预:病例说明

Two-stage surgical intervention for a rare case of intersected nasoethmoidal encephalocele and open-lip schizencephaly in an infant: illustrative case.

作者信息

Suarez-Monsalve Silvia, Campos-Fajardo Santiago, Ramirez-Grueso Raul, Jacomussi-Alzate Karen Lorena, Franco Rodriguez Julie

机构信息

Neurosurgery Research Group, NeuroAxis SAS, Bogotá, Colombia.

Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana Bogotá, Colombia.

出版信息

J Neurosurg Case Lessons. 2024 Nov 4;8(19). doi: 10.3171/CASE24259.

Abstract

BACKGROUND

Schizencephaly and encephaloceles are rare developmental birth defects, with the former involving abnormal clefts in the cerebral hemispheres connected to the ventricular system and the latter involving a neural tube defect characterized by the protrusion of brain tissue through an abnormal skull opening. These conditions are individually uncommon, and their simultaneous occurrence in a single patient is exceedingly unusual.

OBSERVATIONS

This case report explores the intersection of these two rare congenital malformations in a 2-month-old female patient from an indigenous community in a rural area of Colombia. She presented with open-lip schizencephaly accompanied by a nasoethmoidal encephalocele and additional brain abnormalities, including septum pellucidum agenesis, corpus callosum dysgenesis, and a suspected bilateral optic nerve hypoplasia.

LESSONS

Management involved a two-step surgical procedure, addressing hydrocephalus with a ventriculoperitoneal shunt and the encephalocele with posterior excision, thereby facilitating optimal cortical gray matter development and enhancing neurological outcomes. https://thejns.org/doi/10.3171/CASE24259.

摘要

背景

脑裂畸形和脑膨出是罕见的发育性出生缺陷,前者涉及与脑室系统相连的大脑半球异常裂隙,后者涉及一种神经管缺陷,其特征是脑组织通过颅骨异常开口突出。这些情况单独出现并不常见,而在单个患者中同时出现则极为罕见。

观察结果

本病例报告探讨了这两种罕见先天性畸形在一名来自哥伦比亚农村地区土著社区的2个月大女性患者中的交集。她表现为开放性唇裂脑裂畸形,伴有鼻筛脑膨出和其他脑部异常,包括透明隔缺如、胼胝体发育不全以及疑似双侧视神经发育不全。

经验教训

治疗包括两步手术,通过脑室腹腔分流术解决脑积水问题,并通过后路切除术治疗脑膨出,从而促进最佳的皮质灰质发育并改善神经学预后。https://thejns.org/doi/10.3171/CASE24259

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8e5/11539283/ecfe3ec7264e/CASE24259_figure_1.jpg

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